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Perforating eye injuries due to intraocular foreign bodies.

The results of sixty-four perforating eye injuries with intraocular foreign bodies (IOFB) treated at University Hospital over ten years were reported. Compared to an earlier report we found that the population at risk was the same and consisted of patients under 35 years (70%), males (95.3%) and work related (86%). The commonest causes of IOFB were hand hammer (64.1%) and grass cutting (20.3%). We also noted that while the incidence of cases had increased by 23%, the final visual outcome has improved significantly due to advances in preoperative diagnosis and surgical techniques. Preoperative factors found to have a statistically significant effect on the final visual outcome were the size of the IOFB, poor initial visual acuity, and the presence of the following complications: cataract, iris damage and vitreous haemorrhage. The outcome was also worse in posterior segment IOFBs but this was not statistically significant.

Accidents, Occupational↗

Perforating eye injuries caused by darts.

We have reviewed 19 patients with dart-induced perforating eye injuries. Fourteen of the injuries were in childhood. A poor visual outcome was common, not only from the injury directly but also from irreversible amblyopia or endophthalmitis. Preventive measures are considered.

Adolescent↗

Coexistence of intraocular eyelashes and anterior chamber cyst after penetrating eye injury: a case presentation.

We herein describe a patient in whom two intraocular eyelashes and an anterior chamber cyst embedded into the anterior surface of the iris was detected following penetrating eye injury. After a one year asymptomatic period, the patient was hospitalized because of uveitic reaction in the anterior chamber which may be due to cyst development. The lashes and cyst were removed surgically, and examined pathologically. There was no complication in one year follow-up period.

Adolescent↗

Vitrectomy for perforating eye injuries from shotgun pellets.

Pars plana vitrectomy and scleral buckling were performed on 22 eyes of 19 patients for treatment of perforating eye injuries from shotgun pellets. We reviewed the intraoperative findings at the time of vitrectomy to determine what factors might influence final visual acuity. The presence of a total retinal detachment at vitrectomy portended a poor prognosis when compared with eyes without total retinal detachment, as only one of ten eyes with total retinal detachment obtained useful vision (P = .002). Preoperative separation of the posterior vitreous was associated with a favorable outcome when compared with the absence of posterior vitreous detachment (P = .035), as ten of 16 eyes with posterior vitreous detachment at the time of vitrectomy ultimately achieved functional vision. The locations of the exit wounds did not affect visual success in the overall series of patients. However, in the patients who achieved visual success, exit wounds outside the vascular arcades were more likely to be associated with final visual acuities of, or better than, 20/70 than were those within the arcades (P = .022). Other prognostic factors, such as the number of perforations and the use of cryotherapy, were also examined for their effects on final visual outcome. However, these factors did not appear to affect visual outcome statistically.

Adolescent↗

Evaluating eye injury risk of Airsoft pellet guns by parametric risk functions.

Over 2.4 million eye injuries occur each year in the United States as a result of trauma. New toy guns, commonly referred to as Airsoft guns are increasingly becoming responsible for ocular injuries in children. The purpose of this study was to determine the ocular injury risk of these Airsoft guns by experimental testing and the use of previously generated ocular injury risk functions. A total of 26 Airsoft pellet impact tests were performed on both post-mortem human and porcine eyes in a laboratory environment. Projectile parameters of diameter, mass, and velocity were used to calculate the injury potential of these impacts for five different ocular injuries: corneal abrasion, lens dislocation, hyphema, retinal damage, and globe rupture. Globe rupture was not observed in any of the experimental tests, which is consistent with that reported in the literature. The two most likely ocular injuries caused by these Airsoft guns are corneal abrasion and hyphema, at nearly a 100% and a greater than 75% risk of injury, respectively. This is consistent with the types of injuries reported in the literature, with corneal abrasion and hyphema being the most frequently occurring ocular injuries due to Airsoft guns. More experimental data on retinal injuries is necessary to make an accurate assessment of the risk of retinal damage from blunt impacts. In summary, the potential for ocular injury from Airsoft guns is great and protective equipment such as protective eyewear should be considered mandatory during operation.

Animals↗

Iatrogenic open globe eye injury following sinus surgery.

PURPOSE: To report a case of iatrogenic open globe eye injury occurring during endoscopic sinus surgery. DESIGN: Case report and literature review. METHODS: A 10-year-old boy presented with periorbital swelling and subconjunctival hemorrhage of the left eye following bilateral nasal adenoidectomy. Funduscopic examination showed evidence of a full-thickness open globe injury at the equator in the inferior nasal midperiphery. RESULTS: The injury most likely was secondary to inadvertent perforation of the lamina papiracea with entrance into the orbit and subsequent penetration of the globe. CONCLUSION: Sinus surgery has been reported previously in association with severe orbital complications. We are unaware of previous reports of open globe injury following sinus surgery.

Adenoidectomy↗

Initial management and transport of patients with perforating eye injuries.

The first 24 hours are critical for a good surgical result from perforating eye injuries. The basic principles of initial management and transfer include prevention of vomiting, pain and infection, and avoidance of further injury. Where air transport is necessary it must be with the cabin altitude at sea level, or as low as is safe. Surgical repair should be undertaken as promptly as is practical.

Adult↗